Immuno-inflammatory and organ dysfunction markers in severe COVID-19 patients.

Infection with the SARS-CoV-2 virus may induce some complications among people who experience mild to moderate respiratory illness and some of them recover without requiring special treatment. Albeit, some individuals become seriously reached risk points and require special medical attention especially older people and people who suffer from chronic diseases. Serum and whole blood samples were collected from confirmed infected persons with SARS CoV-2 by real-time PCR and the control group. All lab. Investigations were performed using Cobas 6000. Significant differences were noted between patients compared to the control group in the Mean ± SD of IL-6 (76.06 ± 7.60 vs 3.61 ± 0.296 pg/ml), Procalcitonin (0.947 ± 0.117 vs 0.061 ± 0.007 ng/ml), CRP (125.3 ± 7.560 vs 4.027 ± 0.251 mg/dl), ALT (154.8 ± 30.47 vs 49.75 ± 2.977 IU/L) and AST (70.83 ± 9.215 vs 27.23 ± 1.767) respectively. While other parameters were also showed significant differences were noted between patients compared to the control group for D-Dimmer, PT, PTT, LDH, Ferritin, WBC, Lymphocyte and Creatinine. The results reached that the effect of SARS CoV-2 and cytokine storm was clear on the body's organs through vital biomarker investigations that were performed in this study.

Clinical presentation, diagnosis and management of multisystem inflammatory syndrome in children (MIS-C): a systematic review.

BACKGROUND: Knowledge about multisystem inflammatory syndrome in children (MIS-C) is evolving, and evidence-based standardised diagnostic and management protocols are lacking. Our review aims to summarise the clinical and diagnostic features, management strategies and outcomes of MIS-C and evaluate the variances in disease parameters and outcomes between high-income countries (HIC) and middle-income countries (MIC). METHODS: We searched four databases from December 2019 to March 2023. Observational studies with a sample size of 10 or more patients were included. Mean and prevalence ratios for various variables were pooled by random effects model using R. A mixed generalised linear model was employed to account for the heterogeneity, and publication bias was assessed via funnel and Doi plots. The primary outcome was pooled mean mortality among patients with MIS-C. Subgroup analysis was conducted based on the income status of the country of study. RESULTS: A total of 120 studies (20 881 cases) were included in the review. The most common clinical presentations were fever (99%; 95% CI 99.6% to 100%), gastrointestinal symptoms (76.7%; 95% CI 73.1% to 79.9%) and dermatological symptoms (63.3%; 95% CI 58.7% to 67.7%). Laboratory investigations suggested raised inflammatory, coagulation and cardiac markers. The most common management strategies were intravenous immunoglobulins (87.5%; 95% CI 82.9% to 91%) and steroids (74.7%; 95% CI 68.7% to 79.9%). Around 53.1% (95% CI 47.3% to 58.9%) required paediatric intensive care unit admissions, and overall mortality was 3.9% (95% CI 2.7% to 5.6%). Patients in MIC were younger, had a higher frequency of respiratory distress and evidence of cardiac dysfunction, with a longer hospital and intensive care unit stay and had a higher mortality rate than patients in HIC. CONCLUSION: MIS-C is a severe multisystem disease with better mortality outcomes in HIC as compared with MIC. The findings emphasise the need for standardised protocols and further research to optimise patient care and address disparities between HIC and MIC. PROSPERO REGISTRATION NUMBER: CRD42020195823.

Analysis of travel burden and travel support among patients treated at a comprehensive cancer center in the Southeastern United States.

INTRODUCTION: Travel burden leads to worse cancer outcomes. Understanding travel burden and the level and types of travel support provided at large cancer centers is critical for developing systematic programs to alleviate travel burden. This study analyzed patients who received travel assistance, including their travel burden, types and amount of travel support received, and factors that influenced these outcomes. METHODS: We analyzed 1063 patients who received travel support from 1/1/2021 to 5/1/2023 at Winship Cancer Institute, in which ~18,000 patients received cancer care annually. Travel burden was measured using distance and time to Winship sites from patients' residential address. Travel support was evaluated using the monetary value of total travel support and type of support received. Patients' sociodemographic and clinical factors were extracted from electronic medical records. Area-level socioeconomic disadvantage was coded by the Area Deprivation Index using patient ZIP codes. RESULTS: On average, patients traveled 57.2 miles and 67.3 min for care and received $74.1 in total for travel support. Most patients (88.3%) received travel-related funds (e.g., gas cards), 5% received direct rides (e.g., Uber), 3.8% received vouchers for taxi or public transportation, and 3% received combined travel support. Male and White had longer travel distance and higher travel time than female and other races, respectively. Patients residing in more disadvantaged neighborhoods had an increased travel distance and travel time. Other races and Hispanics received more travel support ($) than Black and White patients or non-Hispanics. Patients with higher travel distance and travel time were more like to receive travel-related financial support. CONCLUSION: Among patients who received travel support, those from socioeconomically disadvantaged neighborhoods had greater travel burden. Patients with greater travel burden were more likely to receive travel funds versus other types of support. Further understanding of the impact of travel burden and travel support on cancer outcomes is needed.

Identification of the RSX interactome in a marsupial shows functional coherence with the Xist interactome during X inactivation.

The marsupial specific RSX lncRNA is the functional analogue of the eutherian specific XIST, which coordinates X chromosome inactivation. We characterized the RSX interactome in a marsupial representative (the opossum Monodelphis domestica), identifying 135 proteins, of which 54 had orthologues in the XIST interactome. Both interactomes were enriched for biological pathways related to RNA processing, regulation of translation, and epigenetic transcriptional silencing. This represents a remarkable example showcasing the functional coherence of independently evolved lncRNAs in distantly related mammalian lineages.

Johanson-Blizzard Syndrome: A Case Report From Bahrain With a Literature Review.

Johanson-Blizzard syndrome (JBS) is a rare hereditary autosomal recessive disorder caused by a mutation in the ubiquitin protein ligase E3 component n-recognin 1 (UBR1) gene. This syndrome is characterized by the following typical clinical features: hypoplasia or aplasia of the alae nasi, congenital scalp defects, sensorineural hearing loss, hypothyroidism, growth retardation, psychomotor retardation, imperforate anus, genitourinary anomalies, and atypical hair patterns. Here, we describe a case of a 12-year-old girl with JBS of consanguineous parents. During the last trimester of pregnancy, a congenital abnormality affecting the nose was detected. Immediately after birth, the clinical examination revealed dysmorphic features in the form of hypoplastic alae nasi, microcephaly, mild hypotelorism, and cutis aplasia on the scalp. The genetic testing of the patient showed a novel sequence change mutation of the UBR1 gene (1bp duplication causing a frameshift), while both parents were carriers for this mutation. Moreover, a diagnosis of pancreatic insufficiency and subclinical hypothyroidism was made based on clinical presentation and laboratory results. The patient was started on pancreatic enzyme replacement therapy and fat-soluble vitamins, minerals, and antioxidant syrup. Further assessment revealed hypotonia, growth impairment, delay in reaching developmental milestones, and bilateral profound sensorineural hearing loss, which was managed with bilateral cochlear implantation. In addition, the patient underwent multiple craniofacial reconstructive surgeries. This case report highlights the importance of early diagnosis and multidisciplinary care of patients with JBS.

Immunological studies on the effects of toltrazuril and neem extract in broiler chickens suffering from coccidiosis.

Background: The prevalence of avian coccidiosis in the poultry industry has grown, resulting in substantial financial losses from high mortality, stunted growth, reduced productivity, and expensive medical expenses. Aim: The purpose of the current study was to assess the immunological effects of neem leaf extract and toltrazuril on broilers that had contracted coccidiosis. Methods: In this investigation, 100 one-day-old Cobb broiler chicks without sexes were employed. The chicks were divided into five equal groups, with 20 birds in each. On the 14th day of life, the birds in groups 2, 3, 4, and 5 received an oral inoculation with 1 × 105 sporulated oocysts of Eimeria tenella (E. tenella) (field isolate). The first group (Gp), which consists of 20 healthy broilers, served as a negative control. Gp (2) contains experimentally infected broilers and nontreated (served as a positive control). Gp (3) contains experimentally infected broilers treated with toltrazuril (1 ml/l drinking water) for two consecutive days. Gp (4) contains experimentally infected broilers treated with neem leaf extract 4% (50 ml/l drinking water) for 5 successive days, and Gp (5) contains experimentally infected broilers treated with toltrazuril (1 ml/l drinking water) and a half dose of neem leaves extract 4% (25 ml/l drinking water) for 5 successive days. For the purpose of estimating body weight growth and feed conversion ratio, each broiler was weighed separately at the start of the trial and again on the 1st and 10th day after treatment. In addition to obtaining intestinal samples for immunohistochemistry, blood samples were also obtained for immunological examination. Results: As compared to the negative control group, the experimentally infested broilers with E. tenella showed significant decreases in serum nitric oxide, lysosome, phagocytic percent, and phagocytic index, along with significant increases in white blood cells (WBCs), lymphocyte, heterophilis, eosinophilis, basophilis, monocyte, serum total protein, γ globulin, fibrinogen, and haptoglobin. When compared to the control positive group, experimentally infested broilers treated with either neem or toltrazuril alone or in combination demonstrated significant increases in serum total protein, nitric oxide, lysozyme, phagocytic percent, and phagocytic index, but significant decreases in WBCs, lymphocytes, heterophile, eosinophile, basophile, and monocyte. The intestinal peroxidase stain of broilers infected with E. tenella exhibited a significant positive expression for CD4, but the infected broilers treated with toltrazuril and half a dosage of neem displayed a negative expression for CD4, identical to the negative control. Conclusion: The broiler chickens infested with E. tenella may have a variety of negative impacts on their immune systems and immunohistopathological findings. Nonetheless, toltrazuril and neem extract, either separately or in combination, function as anticoccidial medications that may enhance the broiler chicks' immune state.

Navigating complexity of the medication management system within the home setting-a functional resonance analysis method (FRAM) analysis of people with dementia and their carers' experiences.

BACKGROUND: There is a strong imperative to support people with dementia to live independently in their homes for as long as possible. A starting point is to understand how they manage medications on a daily basis. AIM: To understand how people with dementia and their informal carers manage medications within the home setting to inform the identification of opportunities to improve medication management. METHODS: A qualitative study using the Functional Resonance Analysis Method (FRAM). Interview data with people with dementia and informal carers were analysed to (i) Identify and describe key functions, (ii) identify and describe variability in performing key functions, and its potential consequences and (iii) map performance variability to Resilient Healthcare capacities. RESULTS AND DISCUSSION: A FRAM model was developed and consisted of 14 interdependent key functions. The interdependent nature of functions, and the different nature and sources of variability in how each key function was performed highlighted the level of complexity of the medication management system within the home setting. The medication system was managed almost entirely by the person with dementia and/or their informal carers. This shows the lack of system-level controls to support the safe functioning of the medication management system in the home setting. CONCLUSION: Future work will develop a comprehensive FRAM model that includes the perspectives of health and social care professionals and those from the third sectors to underpin the development of a range of system recommendations to strengthen resilience in the medication management system within the home setting.

Modifiable and Non-Modifiable Risk Factors for Premature Coronary Heart Disease (PCHD): Systematic Review and Meta-Analysis.

AIM: We aimed to compare the prevalence of modifiable and non-modifiable coronary heart disease (CHD) risk factors among those with premature CHD and healthy individuals. METHODS: PubMed, CINAHL, Embase, and Web of Science databases were searched (review protocol is registered in PROSPERO CRD42020173216). The quality of studies was assessed using the National Heart, Lung and Blood Institute tool for cross-sectional, cohort and case-control studies. Meta-analyses were performed using Review Manager 5.3. Effect sizes for categorical and continuous variables, odds ratio (OR) and mean differences (MD)/standardised mean differences (SMD) with 95% confidence intervals (CI) were reported. RESULTS: A total of n=208 primary studies were included in this review. Individuals presenting with premature CHD (PCHD, age ≤65 years) had higher mean body mass index (MD 0.54 kg/m2, 95% CI 0.24, 0.83), total cholesterol (SMD 0.27, 95% CI 0.17, 0.38), triglycerides (SMD 0.50, 95% CI 0.41, 0.60) and lower high-density lipoprotein cholesterol (SMD 0.79, 95% CI: -0.91, -0.68) compared with healthy individuals. Individuals presenting with PCHD were more likely to be smokers (OR 2.88, 95% CI 2.51, 3.31), consumed excessive alcohol (OR 1.40, 95% CI 1.05, 1.86), had higher mean lipoprotein (a) levels (SMD 0.41, 95% CI 0.28, 0.54), and had a positive family history of CHD (OR 3.65, 95% CI 2.87, 4.66) compared with healthy individuals. Also, they were more likely to be obese (OR 1.59, 95% CI 1.32, 1.91), and to have had dyslipidaemia (OR 2.74, 95% CI 2.18, 3.45), hypertension (OR 2.80, 95% CI 2.28, 3.45), and type 2 diabetes mellitus (OR 2.93, 95% CI 2.50, 3.45) compared with healthy individuals. CONCLUSION: This meta-analysis confirms current knowledge of risk factors for PCHD, and identifying these early may reduce CHD in young adults.

Risk of venous thromboembolism in patients with rheumatoid arthritis: a meta-analysis of observational studies.

BACKGROUND: Thrombotic events, such as venous thromboembolism (VTE) are a major health complication linked to rheumatoid arthritis (RA). We performed a meta-analysis to evaluate the risk of VTE, including deep vein thrombosis (DVT) and pulmonary embolism (PE), in adults with RA compared to the general population. METHODS: MEDLINE and EMBASE databases were searched from inception to April 2022 to identify publications meeting the following criteria: (1) prospective and retrospective original data from cohort or case-control studies; (2) pre-specified RA definition; (3) clearly defined VTE outcomes; (4) reported risk estimate and 95% confidence intervals (95% CIs); (5) at least sex- and age-matched to comparison group; and (6) English language. Of 372 studies screened, 14 were included (602,760 RA patients, 123,076 VTE events) and their quality was assessed by an adaptation of the STROBE quality scoring scale. RESULTS: The pooled risk ratios of VTE, DVT and PE in patients with RA were 1.57 (95% CI 1.41-1.76), 1.58 (95% CI 1.26-1.97) and 1.57 (95% CI 1.30-1.88), respectively. The I2 value of 92%, 94% and 92% for VTE, DVT and PE analyses, suggesting considerable heterogeneity. There were no significant differences in risk estimates among the five subgroup analyses: quality score (P = 0.35, I2 = 0%); sex (P = 0.31, I2 = 1.7%); study year (P = 0.81, I2 = 0%); population source (P = 0.35, I2 = 0%); study design (P = 0.62, I2 = 0%). CONCLUSIONS: Results show that patients with RA are at a higher risk of VTE, DVT and PE compared to the general population.

Knowledge, Attitude, and Practice Toward Dietary Salt Intake Among Medical Students at King Abdulaziz University.

Background Since the beginning of the century, dietary patterns have been changing rapidly due to evolving lifestyles, restaurants that cater to dietary restrictions, etc. As a result, populations started consuming a large amount of salt in their diets. Years of research have found that high salt intake is strongly related to many serious health problems like hypertension and cardiovascular diseases. This study's objective is to evaluate knowledge, attitudes, and practices regarding dietary salt intake among medical students at King Abdulaziz University (KAU) in Jeddah, Saudi Arabia, and to identify barriers and concerns related to optimum dietary sodium intake. Method A cross-sectional study done at KAU among 310 students using an online questionnaire included items to assess their knowledge, attitudes, and practices related to dietary salt intake. There were 24 questions to assess knowledge, six questions to assess attitude, and eight questions to assess practice. Results The mean age of the participants was 21.52 ± 1.94 years; 180 of the 57.5% were female. A score of "1" was given to the right answer for knowledge, positive attitude, and correct practice. The mean knowledge, attitudes, and practices scores were 16.99 ± 3.8, 3.03 ± 1.46, and 2.13 ± 1.34, respectively. The percentage of poor, fair, and good knowledge levels regarding dietary salt intake among studied students was 72:23%, 210:67.1%, and 31:9.9%. While the prevalence of negative, fair, and positive attitudes was 111:35.5%, 141:45%, and 161:9.5%. As for practice level, none of the students had good practice, while 263:84% and 50:16% had poor and fair practice, respectively. Conclusion In conclusion, the majority of students were aware that a high-salt diet can result in serious health issues. They were also uncertain of whether their salt intake was extremely high or not, which is consistent with the fact that they were ignorant of the daily salt intake guidelines. The findings in our study can stand as a reference point for salt-related knowledge, attitude, and practice (KAP) studies to help further future research in Saudi Arabia and other countries. Multi-sector coordination between the food suppliers, health agencies, and government is necessary to increase public awareness, decrease the salt content of food, and lower individual salt consumption in Saudi Arabia.

Gastroprotective effect of rhodanine and 2,4-thiazolidinediones scaffolds in rat stomachs by contribution of anti-apoptotic (BCL-2) and tumor suppressor (P53) proteins.

In recent times, the methods used to evaluate gastric ulcer healing worldwide have been based on visual examinations and estimating ulcer dimensions in experimental animals. In this study, the protective effect of rhodanine and 2,4-thiazolidinediones scaffolds compared to esomeprazole was investigated in an ethanol model of stomach ulcers in rats. Pretreatment with experimental treatments or esomeprazole prevented the development of ethanol-induced gastric ulcers. The severity of the lesions and injuries was significantly lower than that of vehicle (10% Tween 80) treated rats. Significant and excellent results were obtained with the compound 6 group, with inhibition percentage and ulcer area values of 97.8% and 12.8 ± 1.1 mm2, respectively. Synthesized compounds 2, 7 and 8 exhibited inhibition percentages and ulcer areas of 94.3% and 31.2 ± 1.1 mm2, 91. 3% and 48.1 ± 0. 8 mm2, 89. 5% and 57. 6 ± 1. 2 mm2, and 89. 1% and 60.3 ± 0. 8 mm2, respectively. These biological outcomes are consistent with the docking studies in which Compounds 7 and 8 showed remarkable binding site affinities toward human H+/K+-ATPase α protein (ID: P20648), rat H+/K+-ATPase α protein (ID: P09626), and Na+/K+-ATPase crystal structure (PDB ID:2ZXE) with binding site energies of - 10.7, - 9.0, and - 10.4 (kcal/mol) and - 8.7, - 8.5, and - 8.0 (kcal/mol), respectively. These results indicate that these test samples were as effective as esomeprazole. Likewise, immunohistochemical staining of antiapoptotic (BCL2) and tumor suppressor (P53) proteins showed strong positive marks in the10% Tween 80- treated group, opposing the mild staining results for the esomeprazole-treated group. Similarly, the staining intensity of the group treated with Compounds 2-8 was variable for both proteins.

Causes and Pattern of Chest Trauma Among Adults: A Scoping Review of Studies From the Middle East.

Chest trauma incidence is increasing worldwide, and it requires attention as it is a major cause of morbidity and mortality. Worldwide, chest trauma is the second most common cause of mortality and a major cause of disability and hospitalization. Our main aim is to systematically review the prevalence, pattern, causes, manner, morbidity, and mortality of chest trauma in the Middle East among adults. This scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Screening of the relevant articles was done by using databases, including PubMed, Scopus, and Web of Science. A total of 128 articles were found as a result of searching the databases and reviewing the reference lists. Finally, nine articles met the inclusion criteria. Most of the victims were males, as reported by all studies in this systemic review. The most common cause of chest trauma was road traffic accident (RTA), as described in seven out of the nine included studies. The pattern of chest trauma included pneumothorax, hemothorax, hemopneumothorax, lung contusion, flail chest, rib fracture, and diaphragmatic injury. The rate of mortality and morbidity following chest trauma varied among the studies. However, most of the studies revealed higher rates of morbidity than mortality. Chest trauma carries economic and social burdens, and it is a serious issue, especially in males in the second to third decades. Preventive measures should be considered to decrease the prevalence of chest trauma and its related complications.

A Study on Patient Safety Incidents and the Second Victim Phenomenon Among Healthcare Providers in Al-Ahsa, Saudi Arabia.

BACKGROUND: A second victim (SV) is a healthcare worker who is traumatized by an unexpected adverse patient case, therapeutic mistake, or patient-associated injury that has not been anticipated. Often, the second victim experiences direct guilt for the harm caused to the patients. Healthcare organizations are often unaware of the emotional toll that adverse events can have on healthcare providers (HCPs) who can be harmed by the same incidents that harm their patients. Second victims (SVs) were present in 10.4% up to 43.3% of cases following an adverse event. AIM: This study aims to examine the second victim phenomenon among healthcare providers at Al-Ahsa hospitals, its prevalence, symptoms, associated factors, and support strategies. METHODS: Four major public hospitals participated in this cross-sectional study. The study used the German standardized questionnaire "SeViD-I survey." The directors of the four hospitals sent invitations with links to participate to healthcare providers who had worked in their hospitals for over six months after completing their internship program. RESULTS: More than one-quarter of the respondents (90 (28%)) have been victims of a second victim incident before; of those, 63 (70%) have had it once, 12 (13.3%) twice, and 15 (16.7) repeatedly. In our study, the risk factors for a second victim only appeared in the male gender and were statistically significant. Strong reactivation of situations outside of the workplace was reported in 36 (40%) participants. Thirty-five (38.9%) participants reported reactivating the situation on the job site. Twenty-eight (31%) participants reported aggressive psychosomatic reactions (headaches and back pain). In 28 (31.1%) participants, sleep problems or excessive sleep needs were pronounced. The median of feeling symptoms was 7.2. As for supporting strategies, 64 (71.1%) respondents considered emotional support and crisis management to be very helpful. Sixty-six (73.3%) respondents found a safe chance to be very helpful. CONCLUSION: The findings of this study indicate that healthcare providers in Al-Ahsa, Saudi Arabia, suffer from second victim traumatization at high rates. Several symptoms appear in the second victim, and most do not receive enough support.

Secondary Traumatic Stress Disorder Among Physiotherapists Working in High Morbidity Departments: A Cross-Sectional Study.

Purpose: This study's objective was to measure secondary traumatic stress disorder among Saudi Arabian physiotherapists employed in the critical care, neurology, cardiology, pulmonology, and mental health fields. Also, to identify the factors related to secondary traumatic stress. Methods: Between July 2021 and June 2022, a cross-sectional study involving physiotherapists from the critical care, emergency, neurology, cardiology, pulmonology, and mental health departments was carried out. Data were collected from the participants by using the validated Secondary Traumatic Stress Scale (STSS). Appropriate Statistical analysis (bivariate and multivariate) was carried using SPSS 21.0 software to analyse the data. Results: We quantified the prevalence of secondary traumatic stress, among 201 healthcare professionals (physiotherapists) in total were assessed; of them, 23.4% worked in the medical/surgical and neurosurgical departments and 5% in the critical care and emergency departments. Twenty-four percent of the participants slept less than five hours each day, and 26.4% worked more than 45 hours per week. Our study subjects had mild STS in 25.4% of cases, moderate stress in 15.9%, high STS in 15.9% and severe STS in 30.9% of cases. The intrusion score (mean = 11.65), avoidance score (mean = 5.5), arousal score (mean = 4.1) and total mean score of 42.50 of the STSS were significantly different across the age groups, marital status and years of experience of study participants. The regression analysis shows age groups and severe stress were independently related to the total STS scores. Conclusion: The study has found out higher level of STS among physiotherapists which highlights the necessity for a variety of interventional programs to be implemented in hospital settings in order to enhance communication abilities, lessen emotional discomfort, and apply relaxing techniques.

Factors associated with the prevalence of depression and anxiety among parents of children with neurodevelopmental disorders in Saudi Arabia.

BACKGROUND: Neurodevelopmental disorders (NDDs) are a group of conditions that include attention-deficit/hyperactivity disorders, specific learning disorders, autism spectrum disorder, intellectual disability, and other disorders. Raising a child with an NDD can be difficult because it affects the social lives of the parents and their relationships. It also requires the parents to develop another set of skills to deal with their child. These factors increase their risk of depression and anxiety. AIM: To measure the prevalence rates of depression and anxiety among parents of children with different NDDs, compare the rates between mothers and fathers, and measure the relevant associated factors. METHODOLOGY: This study was a prospective, qualitative, cross-sectional, anonymous questionnaire-based study. The participants were 416 parents of children with NDDs in Saudi Arabia. The sample size was determined using the Richard Geiger equation with a 5% margin of error, a 95% confidence level, and a 50% response distribution. The screening was performed using a validated Arabic version of the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7). These are short and understandable screening tools that assist in identifying and grading the severity of depression and anxiety symptoms. The participants were reached by distributing the questionnaire to parents who followed up with Saudi NDD-related associations, clinics, and psychiatric clinics from November 20 to May 8, 2022. The data were collected, reviewed, and then entered into SPSS 21. RESULTS: In total, 416 parents of children with NDDs in Saudi Arabia participated in the study. We demonstrated that 85.1% of parents of children with NDDs had depression and that 85.8% had anxiety. Mothers and fathers had similar rates of depression and anxiety. No significant difference was found between the type of NDD and rates of depression and anxiety in parents. CONCLUSION: Children with NDDs affect their parents' mental health in terms of increased rates of depression and anxiety. This increase is not correlated with a specific etiology. Healthcare professionals who care for children with NDDs should also assess parental mental health and seek an early diagnosis of mental illness to ensure that the appropriate interventions are provided for parents.

Diclofenac sodium and dexamethasone co-therapy restores brain neuron-specific enolase (NSE), S-100 Beta and glial fibrillary acid protein (GFAP) proteins in experimental rat's model: A possible inhibition of P-glycoprotein.

Non-steroidal anti-inflammatory drugs decrease pain and fever while corticosteroids regulate inflammation and immune response, both are prescribed to reduce inflammation and control pain. The present study aimed to study the effects of their monotherapy and co-administration on the brain tissue structure of experimental rats. P-glycoprotein (PGP), a transporter membrane protein, plays an important role in various physiological and physio-pathological conditions, drug-drug and drug-food interactions, and multi-drug resistance. Male rats were divided into four groups and received normal saline, dexamethasone, diclofenac sodium and their dual therapy respectively, then after one-month rats were sacrificed and brain tissues proceeded for hematoxylin and eosin staining to study their histopathology and immunohistochemically staining of NSE, S100-B and GFAP biomarkers were performed. Additionally, in silico molecular docking studies were conducted to elucidate interactions between PGP and used compounds. Resultsshowed that dexamethasone or diclofenac sodium treatments showed abnormalities like edema, neuronal vacuoles, astrocytes hyperplasia and microglial cells with positive reaction to NSE, S100 and GFAP antibodies while the dual therapy displayed less edema and other signs of damage with negative and weak positive staining of NSE, S100 and GFAP antibodies respectively. The molecular docking showed that there were different affinities toward the involved PGP active site. These interaction results were great with Dexamethasone -9.6 kcal/mol forming hydrophobic interactions with the highest affinity when compared with Diclofenac sodium which gave -8.4 kcal/mol. In conclusion, the side effects of the two types of anti-inflammatory drugs may be minimized through their interactions. However, Molecular Dynamic Simulations studies are required to explain the exact dynamic behaviors and protein-ligand stability.

Systematic Review of Management of Moderate Wasting in Children over 6 Months of Age.

The effective management of the 33 million children with moderate acute malnutrition (MAM) is key to reducing childhood morbidity and mortality. In this review, we aim to evaluate the effectiveness of specially formulated foods (SFFs) compared to non-food-based approaches to manage MAM in children >6 months old. We conducted a search on ten databases until 23 August 2021 and included five studies, covering 3387 participants. Meta-analysis of four studies comparing SFFs to counselling or standard of care showed that SFFs likely increase recovery rate, reduce non-response, and may improve weight-for-height z-score, weight-for-age z-score and time to recovery, but have little or no effect on MUAC gain. One study on a multicomponent intervention (SFFs, antibiotics and counselling provided to high-risk MAM) compared to counselling only was reported narratively. The intervention may increase weight gain after 24 weeks but may have little or no effect on weight gain after 12 weeks and on non-response and mortality after 12 and 24 weeks of enrollment. The effect of this intervention on recovery was uncertain. In conclusion, SFFs may be beneficial for children with moderate wasting in humanitarian contexts. Programmatic recommendations should consider context and cost-effectiveness.

Long-range Through-space Charge Transfer in a pH-responsive Mixed Cyclophane of Pyridine and Teropyrene.

A large, strained (SE=44.2 kcal/mol) and conformationally flexible mixed cyclophane of pyridine and teropyrene was synthesized using two intramolecular Wurtz coupling reactions and an unprecedented Scholl reaction between the unreactive 2 positions of the pyrene systems in a triply bridged pyrenophane. Protonation of the pyridine unit results in a greatly enhanced preference for nesting in the cavity of the highly bent teropyrene system (θcalc =162.6°) and emergence of a charge transfer absorption band (λmax =592 nm) due to a long range (5.0-5.5 Å), through-space intramolecular transition between the teropyrene and pyridinium units, which does not exist in the neutral cyclophane.

Associations Between Social Determinants of Health and Psychoneurologic Symptom Clusters in Women With Gynecologic Cancers: A Longitudinal Study.

OBJECTIVES: To evaluate the associations between social determinants of health (SDOH) and psychoneurologic symptom (PNS) clusters in women with gynecologic cancers during cancer treatment. SAMPLE & SETTING: 67 women with gynecologic cancers who received radiation therapy were assessed at baseline, six to eight weeks after treatment, and six months after treatment at oncology clinics in Georgia. METHODS & VARIABLES: Fatigue, pain, sleep disturbances, cognitive impairment, and depressive symptoms were measured to determine a PNS cluster score. Associations between SDOH and PNS cluster scores were assessed using mixed-effect models. RESULTS: Larger mean PNS cluster scores were reported in individuals with less education, lower income, and unemployment, as well as in those living in more disadvantaged neighborhoods. IMPLICATIONS FOR NURSING: Individual- and community-level SDOH and their interactions were associated with more PNS clusters. Studying SDOH at multiple levels depicts how various social disadvantages can exacerbate poor health outcomes.